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The South Carolina Hospital Association is reporting that according to the Hospital Compare website, South Carolina ranks #3 in the nation for the percentage of heart attack patients who receive PCI within 90 minutes of arrival. Top five: 1. Minnesota (93%)2. Vermont (92.9%)3. South Carolina (90%)4. Indiana (88%)5. Massachusetts (88%) This is an incredible achievement […]

The ACC/AHA focused update of guidelines for STEMI and PCI have been released. They offer new insight into which patients should be given thrombolytics prior to transfer for PCI. They also give a “shout out” to Mission: Lifeline! 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 […]

Since the Veteran’s Day activities at Shelter Cove Community Park scheduled for today have been canceled due to inclement weather, I’d thought I’d repeat last year’s dedication to America’s veterans. Happy Veteran’s Day! 11/11/08 To all the brave veterans of America’s wars, the Prehospital 12 Lead ECG blog says “Thank you for your service to […]

My department is starting a 12-lead ECG “case of the month” as part of our continuing education. Each month, I will select an ECG that was transmitted from the field and resulted in a cath lab activation. Whenever possible, I will include the “before” and “after” angiograms so that the paramedics receive feedback about the […]

Hereâ€™s an interesting PowerPoint presentation that corresponds to a previous post. False Positive Cath Lab Activatin C R T Version from momiamd I found slide 14 to be particularly interesting. This is a topic that doesnâ€™t get enough attention. Often the quarterly STEMI meetings go over the success stories but not the failures. Itâ€™s often […]

The Prehospital 12-Lead ECG blog turned 1 yesterday. In that time, there have been 78,164 unique visits, including 65,204 first-time visitors, and 163,084 page loads. ClustrMaps has recorded visits from 155 different countries. I’m not sure what I expected when I started this blog. In fact, I’m not sure I expected anything. I just went […]

Here’s an interesting story from ABC 7 (WLS-TV) in Chicago. “Some heart attack patients in Chicago may face an emergency situation when they are transported to the hospital in one of the city’s ambulances. The reason for that: those vehicles do not carry crucial equipment that can provide the patients with life-saving treatment.” See the […]

Ken Grauer58 Year Old Male, Workout Worry@ Eli — I don’t see AFlutter. That is, I see no indication of regular atrial activity at a rate consistent with AFlutter. Instead, the rhythm is irregularly irregular without P waves = AFib at a controlled ventricular response. In my opinion, one doesn’t need Sgarbossa criteria here to activate the cath lab. So, yes the…
2018-09-13 02:09:24

Vince DiGiulioIs epinephrine harmful in cardiogenic shock?Sorry about that; I copied the quote from the article and my browser automatically changed the "μ" to an "m". Thanks for noticing, and thanks for pointing it out in the most passive-aggressive manner possible.
2018-09-12 16:45:26

Ken Grauer, MDElectrocardiographically Silent High Lateral STEMI EquivalentHi Tom. This is a great case — so NICE that you posted it for others to learned from. But as I commented several times when you sent this case around to our group — the T waves in V2,V3 are disproportionately peaked and transition occurs early (between V1-to-V2) — so the chest leads are NOT…
2018-08-14 08:38:03

Eli58 Year Old Male, Workout WorryAnybody else see the possibility of a LBBB or A-Flutter? I'm not sure if this will make any difference with the treatments but im just trying to interpret it first because if there is a LBBB then it does not meat Sgarbossa criteria and if it is A-Flutter that could explain the hyper acute T's…
2018-07-20 21:29:21